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K Rajeshwari
Email:
[email protected] |
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Prevention of early dental caries in
children (Eur J Paediatr Dent 2010;11(4):181-4 ) |
Early childhood caries is a virulent form of dental caries that can
destroy the primary dentition of toddlers and preschool children. It
occurs worldwide, afflicting predominantly disadvantaged children.
Although Streptococcus mutans is the most likely causative agent,
diet also plays a critical role in the acquisition and clinical expression
of this infection. Early acquisition of S. mutans via vertical or
horizontal transmission is a key event resulting in accumulation of these
organisms to levels exceeding 30% of the total cultivable plaque flora,
which in turn leads to rapid demineralization of the tooth structure.
Affected children may also have other associated health problems, ranging
from local infections to oral pain that manifest as difficulty in eating
and sleeping, and reduced growth. Oral rehabilitation usually consists of
restoration or surgical removal of carious teeth. Although treatment can
be instituted in the dental clinic, it becomes costly when general
anesthesia is required for sedation.
Comment
Primary prevention of early childhood caries has largely been restricted
to counseling the parents regarding proper feeding behavior, oral hygiene
measures and topical antimicrobial therapy to address the infection.
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Writing about exams worries boosts
performance (Science 2011 Jan 14:331(6041):211-3) |
This study tested a psychological intervention designed to improve
students’ scores on high-stakes exams and to increase our understanding of
why pressure-filled exam situations undermine some students’ performance.
It was expected that sitting for an important exam leads to worries about
the situation and its consequences that undermine test performance. It was
tested whether having students write down their thoughts about an upcoming
test could improve test performance. The intervention, a brief expressive
writing assignment that occurred immediately before taking an important
test, significantly improved students’ exam scores, especially for
students habitually anxious about test taking.
Comment
Simply writing about one’s worries before a high-stakes exam can boost
test scores. Clearly expressing feeling and thoughts orally or in writing
about a problem seems to alleviate it to some extent.
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Early treatment of acute otitis media in
children ( N Engl J Med 2011 Jan 13; 364(2): 105-15) |
Recommendations vary regarding immediate antimicrobial treatment versus
watchful waiting for children younger than 2 years of age with acute
otitis media. In this study, 291 children 6-23 months of age with acute
otitis media, were randomized to receive amoxicillin-clavulanate or
placebo for 10 days. Among the children who received amoxicillin-clavulanate,
35% had initial resolution of symptoms by day 2 and 80% by day 7; among
children who received placebo, 28% had initial resolution of symptoms by
day 2, and 74% by day 7. Mean symptom scores over the first 7 days were
lower for the children treated with amoxicillin-clavulanate than for those
who received placebo .The rate of clinical failure was also lower among
the children treated with amoxicillin-clavulanate. Mastoiditis developed
in one child who received placebo. Diarrhea and diaper-area dermatitis
were more common among children who received amoxicillin-clavulanate.
There were no significant changes in either group in the rates of
nasopharyngeal colonization with nonsusceptible Streptococcus
pneumoniae.
Comment
Children with an accurate diagnosis of acute otitis media recover quickly
when they are treated with an appropriate antimicrobial agent.
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